TYPE 2 diabetes has long been considered a progressive, lifelong condition, with significant risk of developing vascular complications. But ongoing research funded by Diabetes UK is changing that view, showing that remission of type 2 is possible for some people.
The number of people in the UK living with diabetes is growing. Two key drivers are people living longer and significant weight gain. The Diabetes Remission Clinical Trial (DiRECT) aims to find out if weight loss can put type 2 diabetes into remission and keep it there.
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Participants receive a low-calorie liquid diet for between eight and 20 weeks. This is followed by support from a healthcare professional to reintroduce healthy food back into the diet and keep the extra weight off for the long term.
The initial results, announced in December 2017, demonstrated that after 12 months, almost half the participants had achieved normal blood glucose levels without having taken any diabetes medication.
“After 12 months, almost half the participants had normal blood glucose levels without medication”
As the trial continues, researchers are also exploring the psychosocial aspects of the intervention, including motivation, behavioural change and social support, and the biology behind the change. They have shown that weight loss of 10 to 15 kilograms is needed to shed excess fat in the liver and pancreas, triggering a return to normal insulin production. Further work is ongoing to understand why some people don’t achieve the same result despite significant weight loss.
The intervention is also affordable. A recent economic study found that, in its first year, it would cost around £1000 per person. NHS England has announced plans to roll out a pilot intervention for 5000 people.
This successful story offers new hope for some people with type 2 diabetes that remission could be a reality. We don’t yet have all the answers and will need to wait for further evidence from DiRECT and the NHS England pilot. In the meantime, we are making hugely exciting steps towards an effective and tailored primary care-based remission intervention being offered to people living with type 2 diabetes.
